title: Challenges of COPD diagnosis.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide and this burden is predicted to increase unless exposure to risk factors is addressed. Diagnosis of COPD is a challenge: COPD is underdiagnosed and frequently misdiagnosed for asthma or other respiratory conditions. Although spirometry is only one parameter for establishing a clinical diagnosis of COPD, lack of routine spirometry is a key cause of COPD misdiagnosis. Differential diagnosis from asthma is essential because the treatment strategies for, and progression and outcomes of, the two conditions vary greatly.
  
  
  METHODS
  Here the authors review methods for the differential diagnosis of COPD and asthma; approaches to improve diagnosis, including case-finding and screening; the identification of specific COPD phenotypes and targeted therapy; and the potential role of exhaled biomarkers in the diagnosis of COPD.
  
  
  CONCLUSIONS
  Methods to diagnose COPD, specifically differential diagnosis from asthma, have improved in recent years. To translate these into clinical practice will require the development of combined guidelines for COPD and asthma that include COPD-asthma overlap syndrome and are based on evidence from randomized controlled trials.
authors.affiliation: University of Aberdeen, Academic Primary Care, Division of Applied Health Sciences , Aberdeen , Scotland +44 1223 96 9808 ; david@rirl.org.
authors.forename: David
authors.initials: D
authors.lastname: Price
authors.forename: Guy
authors.initials: G
authors.lastname: Brusselle
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests / Q000379:methods; D003937:Diagnosis, Differential; D006801:Humans; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D012307:Risk Factors; D013147:Spirometry / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers